North Korea’s leaders are engaged in widespread, systemic human rights abuses against its citizens that could merit charges by the International Criminal Court, according to a new report released by a United Nations human rights organization.

The report, released Monday by the U.N.’s High Commissioner For Human Rights, accused North Korean officials of engaging in the “extermination, murder, enslavement, torture, imprisonment, rape, forced abortions and other sexual violence” of its citizens, along with “persecution on political, religious, racial and gender grounds, the forcible transfer of populations, the enforced disappearance of persons, and the inhumane act of knowingly causing prolonged starvation.”

The report was based on hearings, both public and private, with over 300 witnesses. North Korea did not cooperate with the commission’s request to allow U.N. investigators into the country and did not grant the commission access to information about its human rights practices, according to the report.

North Korea, Employment, Housing and Food Discrimination

The North Korean government regularly uses access to food “as a means of control” over its citizens, with those living in affluent portions of the country receiving more food than those who live in economically challenged areas, the report says.

Food distribution is, in part, based on a socioeconomic system heavily relied upon in North Korea called songbun. Individuals who hail from wealthy, politically favored family lines are generally seen to be favorable to the regime, and thus have greater access to education and employment opportunities, adequate housing and food.

“[The government] privileges certain parts of the country, such as Pyongyang, over others,” the report says, adding that the North Korean regime “failed to take into account the needs of the most vulnerable,” such as children who suffer from malnutrition.

Women are also less likely to have adequate access to food and unrestricted movement, which has resulted “in women and girls becoming vulnerable to trafficking and increased engagement in transactional sex and prostitution,” the report said.

The government’s withholding of food is also meant to “enforce political loyalty” among North Korean citizens. The report charges the government with distributing food only to citizens it considered to be politically viable “at the expense of those [citizens] deemed to be expendable.”

North Korea, Lack of Access to Foreign, Independent Media

The government heavily controls media flowing in and out of North Korea, with the regime regularly monitoring the phone calls of its citizens and censoring media that it does not directly control, the report says.

Citizens are generally only allowed access to state-controlled news and information, such as government-run newspapers and television broadcasts. Short-wave radios that are capable of picking up foreign broadcasts and foreign-made mobile phones are forbidden by law.

But advances in technology are challenging the government’s ability to control all forms of media in the country, the report says. Realizing the government’s limitation on new technology, the regime carries out “regular crackdowns” on citizens who consume foreign media and dole out “harsh punishments” to those who are caught.

Government Abductions and Torture Lead to False Confessions

Perhaps the most troubling portion of the report deals with the North Korean government’s interrogation and confinement of individuals considered to be suspects in politically motivated “crimes.”

A person suspected of a political crime “simply disappears and may never be heard from again,” according to the report. Family members, who are supposed to be notified within 48 hours of a relative’s arrest under North Korean law, often have to bribe officials for information about loved ones, the report says.

The art of “disappearing” political dissidents is meant to send a message to citizens that “anyone who does not demonstrate absolute obedience can disappear at any time for reasons determined solely by, and known only to, the authorities.”

Some who are arrested are taken to interrogation centers, called kuryujang, where suspects are “systematically degraded, intimidated and tortured” with the hopes that authorities will secure a confession. A former official told the U.N. commission that suspects were regularly dunked in water tanks to simulate drowning, hung upside down from shackles attached to walls and crammed in metal cages that were designed to interrupt blood flow, causing portions of a person’s body to swell. Other witnesses reported guards beating inmates with wooden clubs, wheelbarrow handles and gun barrels.

Suspects who were not being interrogated were ordered to “kneel motionless and without speaking” in their detention cells. If someone was caught speaking, “the entire cell had to perform 1,000 squats.” Authorities regularly withheld food as another form of punishment. It is not uncommon for citizens who are held at detention centers to die after several months, the report says.

The Detention Camps That “Don’t Exist”

The interrogation process concludes only after a person confesses to a crime, which often leads to false confessions, the report says. Authorities draft a confession statement that a person must sign, which often contains a clause forbidding a suspect from disclosing the treatment they faced in the interrogation center.

“High-profile” cases often result in a very-public criminal trial that almost always leads to a person being executed. Less-severe criminal cases are referred to the courts for a punishment of execution, imprisonment in an “ordinary prison camp” or short-term incarceration in a “forced-labor” prison camp. Cases that contain little or no political basis are often referred back to law enforcement, and a person is sent back to the kuryujang for further interrogation, the report said.

If a person is banished to a political camp, it’s often for life, according to witnesses sourced in the report. Citizens are never formally educated about the camps, and North Korean officials regularly deny their existence, but “every North Korean knows [about them],” one witness said. “We have a perception that once you are in, there is no way out.”

Guards and some inmates who are released face punishment if they talk about the camps or the treatment of prisoners, the report says, and if a war ever breaks out, guards have been ordered by the Supreme Leader to “eliminate any evidence” of the camps by killing all inmates.

U.N. officials believe the political camps contained 100,000 to 200,000 inmates. Most of the inmates are thought to be men, but the camps also house women and children. One witness recounted how her relatives — a man, a woman and their two children, ages 2 and 4 — were sent to camps after being arrested by law enforcement for alleged political crimes in the early 1980s. Once a person becomes an inmate at a political camp, they are no longer regarded as a North Korean citizen.

Inmates Punished With Torture, Starvation For “Rule-Breaking”

The camps are constructed so that inmates cannot escape. High-voltage electric fences surround the perimeter of the camps; land mines and “pitfalls” litter the grounds beyond the fences. Guards with automatic rifles are ordered to shoot any inmate who tries to escape, “and they are rewarded if they do” (this can sometimes lead to abuses: the report details one case of a guard falsely accusing five inmates of trying to escape with the hope of being rewarded). Inmates who try to escape are later executed if they are not fatally shot.

“Executions and other cruel extrajudicial punishments” are often carried out in the political camps if inmates break the rules, the report says. Inmates who are accused of rule-breaking are subjected to harsh interrogation and torture. Executions are often handed down as punishment for rule-breaking; the executions are carried out in front of other prisoners “to provide a warning for the rest of the inmates.”

Other punishments include solitary confinement, beatings and mutilation. “Children are not spared from even the cruelest of punishments,” the report said. One inmate cited in the U.N. report, who was a child at the time of his imprisonment, recounted an incident in which he dropped a sewing machine at a forced-labor factory. A guard cut off the middle finger of his right hand as punishment. “At the time, I was grateful, really grateful, to the guard because I was only losing a finger instead of a hand,” the witness said.

Withholding food is considered another form of punishment. Witnesses say malnutrition and disease caused from food rationing, or deliberate starvation, frequently led to death. One witness quoted in the report described how an epidemic “killed 200 prisoners in one camp because hungry [inmates] were catching and eating a type of rat that carried [a] disease.”

Guards are under strict orders not to “fraternize with the inmates,” the report said. However, the report concluded that guards and other inmates routinely raped female prisoners. Inmates who became pregnant were often forced to undergo abortions, tortured or executed. On some occasions, infants were killed after they were born. Children who do survive after birth become prisoners themselves.

“Crimes Against Humanity”

The U.N. report found that heinous treatment of its North Korean citizens, particularly women, children and those confined to political camps, is perpetuated by a government “that does not have any parallel in the contemporary world.”

“The fact that [North Korea], as a State Member of the United Nations, has for decades pursued policies involving crimes that shock the conscience of humanity raises questions about the inadequacy of the response of the international community,” the report concluded. “The United Nations must ensure that those most responsible for the crimes against humanity committed [by the government] are held accountable.”

One way to do this is for the U.N. Security Council to refer North Korean officials, including Supreme Leader Kim Jong-un, to the International Criminal Court for possible charges. The government’s use of extermination, murder, torture and enslavement, particularly in prison camps, violates international law, the report says.

“The suffering and tears of the people of North Korea demand action,” U.N. Commission Chairman Michael Kirby said at a recent press conference, adding that North Korea’s crimes were “strikingly similar” to those perpetrated by Nazi Germany.

“Too many times, in this building, there are reports and no action,” Kirby said. “Well, this is a time for action. We can’t say we didn’t know. We now all do know.”

The non-governmental organization Human Rights Watch urged the United Nations to act on the report, saying the “devastating findings of this inquiry should not be ignored.”

“Since the crimes were perpetrated by state actors, only an international tribunal can properly carry out criminal investigations aimed at holding perpetrators accountable,” Kenneth Roth, the executive director of Human Rights Watch, said in a statement.

North Korean officials dismissed the report shortly after it was published on Monday, calling it a political instrument “aimed at sabotaging the socialist system by defaming the dignified images of [North Korea].”

It seems nothing will change of North Korea’s own accord anytime soon: early Wednesday morning, Voice of America reported that a 75-year-old Christian missionary from Australia had been detained by authorities for possessing “Gospel tracts in the Korean language.” Officials in Canberra are now working with Swedish officials in Pyongyang to secure the man’s release.